Dr. A. Sells Me Down the River

October 2008-June 2009

October 22, I received Dr. A.’s medical notes from my appointment with him, on August 15. Now, instead of osteotomies, missing turbinates and tissue, and collapsed nasal valves, I had a “body dysmorphc disorder.” In other words, there was nothing wrong with my nose. The problem was in my head.

I had made an appointment with Dr. A., for October 24. His office called the day before and cancelled it. I ended up seeing him on October 31—Halloween. Everyone was in costume. Dr. A. was dressed up as a doctor.

Dr. A. brought a photo of my face up on the computer. First, he added 2 mm. or 2 cm.—I don’t recall which—and the nose looked better. But the pulled-up nostrils and other issues still needed to be addressed.

Then Dr. A. made some adjustments to the photo, scaling down what is left of my nose, to a hideous pencil-thin joke of a nose—reducing the bulb—to match what has been amputated from the upper two-thirds. He insisted that this was what he would HAVE to do as “normal” cephalometrics—according to today’s standards of beauty–required him to do this horrific thing to my nose.

I told him that the image of the nose was hideous. I pointed out that he had told me on August 5 that he would rotate the tip of the nose down. He said he would not do it. I asked why.

“Because it’s really hard to do,” he said. Not true. Rotation of the tip is one of the most commonly done nasal procedures in rhinoplasty. I knew he was making inappropriate treatment suggestions in order to get rid of me.

I took out a close-up photo of my face taken just before the surgery of 10-30-07. I pointed out the much greater size of my real nose.

“I am not going to give you a nose that does not reflect the current cultural standard of beauty,” he said.

“I’d like to speak to you alone,” I said. The resident, Dr. N., left the room.

I got out Dr. A’s 8-15-08 report. “There is not one true statement in this report,” I said. I started with the nasal reconstruction. “I told you I did not have a nasal reconstruction.”

“You had a septoplasty,” he said. “I consider that a nasal reconstruction.”

“…which she believes has resulted in excessive narrowing of her nose,” I read. “Dr. A., you told me on July 2 that I’d had osteotomies—or a nose job. I asked you why? You said, ‘because he thought your nose was too wide. He just went too far.”

“No, I didn’t,” he said. “I did not say he went too far.”

“Oh, yes, you did. That is what you said.”

“No, no,” he said. “I didn’t say that.”

“Your findings are stated in your report of July 2,” I pointed out.

“My resident wrote that,” he said.

“Dr. A.,” I said. “You spoke to Dr. F.”

“Yes,” he said.

“His partner, Dr. S., said that there had been no changes to my nose from the surgery. Dr. F. did not want me to come here.”

“I did not call Dr. F.,” Dr. A. said.

“No,” I said. “He called you.”

“No,” Dr. A. said, changing what he had just said. “I did not speak to Dr. F.”

“Then you spoke to someone at the medical center,” I said. “You completely changed your opinion from July 2 to August 15. I saw Dr. F. on June 27. I told him I was seeing someone here. He called you after July 2.”

Dr. A. went into a long, irrelevant monologue about how he does not like to read what other surgeons have written. With this detour, he neatly steered the conversation away from the issue about speaking to Dr. F.

I said. “So you never read the reports from my surgery?”

He said, no, he hadn’t, and added that he does not think it is good to read about what other doctors have done. It gets in the way of his own thinking.

I didn’t ask why his office had requested that I bring all my records. I felt cheated that he had not read my records or looked at my scans. I was upset to realize that he had never understood my case, or cared to.

Dr. A. concluded that he was not the right surgeon for me since we didn’t agree on aesthetics.

Since that Halloween day, October 31, 2008, I have seen three more plastic surgeons, and have been referred on by all. No plastic surgeon wants to get involved where another surgeon has caused the disaster. God forbid, they should be called upon to testify in a court case. A doctor cannot testify against another doctor without being ostracized by the medical community. But beyond that, in order to help me, a surgeon would have to document what is wrong with me, and how it happened. He/she would have to say, in effect, that another doctor harmed me. No doctor will say that. One plastic surgeon said to me, “I can’t fix this.” “Why not?” I asked, knowing that his specialty is facial reconstruction. “Because,” he said, “This isn’t what I do. I fix faces that have been harmed by accident.”